Vertebrobasilar circulatory disorders are conditions in which blood supply to the back of the brain is disrupted.
Vertebrobasilar insufficiency; Posterior circulation ischemia
Causes, incidence, and risk factors
Three main blood vessels provide blood flow to the back of the brain:
One basilar artery
Two vertebral arteries
This part of the brain contains structures that are crucial for keeping a person alive, such as breathing, heart rate, swallowing, vision, movement, and posture or balance.
Many different conditions may cause blood flow in the back part of the brain to be reduced or stopped. The most common are smoking, highblood pressure, diabetes, and high cholesterol levels. These are similar to the
Vertebrobasilar vascular disorders may also be caused by a tear (dissection) in an artery wall.
Other less common causes of vertebrobasilar vascular disorders include connective tissue diseases and vasculitis.
Most common symptoms may include:
- Difficulty saying words
- Difficulty swallowing
- Double vision or vision loss
- Numbness or tingling most often on the face or scalp
- Slurred speech
- Sudden falls (drop attacks)
- Vertigo (sensation of things spinning around)
- Memory loss
Other symptoms that may occur include:
- Bladder or bowel control problems
- Difficulty walking (unsteady gait)
- Hearing loss
- Muscle weakness
- Nausea and vomiting
- Neck ache
- Pain in one or more parts of the body, which gets worse with touch and cold temperatures
- Sleepiness or even apparent sleep from which the person cannot be awakened
- Sudden, uncoordinated movements
- Sweating on the face, arms, or legs
Signs and tests
Tests depend on the possible underlying cause, but may include:
- CT or
MRIof the brain
- Computed tomography angiography (CTA), magnetic resonance angiography (MRA), or
ultrasoundto look at blood vessels in the brain
- Blood tests, including blood clotting studies
Echocardiogram Electrocardiogram(ECG) and Holter monitor
- X-rays of the arteries (
Sudden onset of vertebrobasilar symptoms is a medical emergency that requires immediate treatment. Treatment is similar to that for
- Blood-thinning medications to lower your risk of stroke, such as aspirin, warfarin (Coumadin) or clopidogrel (Plavix)
- Diet changes and medication to lower cholesterol and control blood pressure
- Losing weight
- Stopping smoking
The outlook depends on:
- The type of stroke
- The amount of brain damage
- What body functions have been affected
- How quickly you get treatment
- How quickly you recover
Each person has a different recovery time and need forlong-term care. Problems with moving, thinking, and talking often improve in the first weeks or months after a stroke. Some people will keep improving months or years after a stroke.
Complications of vertebrobasilar circulatory disorders are stroke and its complications. The complications of stroke include:
- Respiratory (breathing) failure (which may require use of a machine to help the patient breathe)
- Lung problems (especially lung infections)
- Heart attack
- Dehydration and swallowing problems (sometimes leading to the placement of tubes in the stomach for artificial feeding)
- Problems with movement or sensation, including paralysis and numbness
- Formation of clots in the legs
Patients may have vision loss in one eye.
Complications caused by medications or surgery may also occur.
Calling your health care provider
Call 911 or your local emergency number, or get to the emergency room if you have any symptoms that may suggest a vertebrobasilar circulatory disorder.